(1) Background: Ultraviolet (UV) radiation and sunburns are associated with an increased
incidence of acquired nevi and melanomas. However, the data are controversial as to whether chronic
UV exposure or high intermittent UV exposure is the major carcinogenic factor in melanocytic tumors.
In this study, we compared the degree of actinic elastosis (AE) as a surrogate for lifetime UV exposure
in nevi and different clinical melanoma subtypes (i.e., superficial spreading melanoma (SSM), nodular
malignant melanoma (NMM), acral lentiginous melanoma (ALM), and lentigo maligna melanoma
(LMM)) with respect to clinical variables (age, sex, and body site). (2) Methods: We defined a
semi-quantitative score for the degree of AE ranging from 0 = none to 3 = total loss of elastic fibers
(basophilic degeneration) and multiplied it by the perilesional vertical extent (depth), measured
histometrically (tumor-associated elastosis grade (TEG)).We matched the TEG of n = 595 melanocytic
lesions from 559 patients with their clinical variables. (3) Results: The TEG was correlated with age
and UV-exposed body sites. Furthermore, the TEG was significantly higher in LMM than in all other
types of melanomas and the TEG in NMM was higher than in SSM, irrespective of patient age and
tumor site. (4) Conclusions: High cumulative UV exposure is more strongly associated with LMM
and NMM than with other melanoma subtypes.